Dosimetric comparison of axilla and groin radiotherapy techniques for high-risk and locally advanced skin cancer
Identifieur interne : 000850 ( Pmc/Curation ); précédent : 000849; suivant : 000851Dosimetric comparison of axilla and groin radiotherapy techniques for high-risk and locally advanced skin cancer
Auteurs : Malcolm D. Mattes [États-Unis] ; Ying Zhou [États-Unis] ; Sean L. Berry [États-Unis] ; Christopher A. Barker [États-Unis]Source :
- Radiation Oncology Journal [ 2234-1900 ] ; 2016.
Abstract
Radiation therapy targeting axilla and groin lymph nodes improves regional disease control in locally advanced and high-risk skin cancers. However, trials generally used conventional two-dimensional radiotherapy (2D-RT), contributing towards relatively high rates of side effects from treatment. The goal of this study is to determine if three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), or volumetric-modulated arc therapy (VMAT) may improve radiation delivery to the target while avoiding organs at risk in the clinical context of skin cancer regional nodal irradiation.
Twenty patients with locally advanced/high-risk skin cancers underwent computed tomography simulation. The relevant axilla or groin planning target volumes and organs at risk were delineated using standard definitions. Paired t-tests were used to compare the mean values of several dose-volumetric parameters for each of the 4 techniques.
In the axilla, the largest improvement for 3D-CRT compared to 2D-RT was for homogeneity index (13.9 vs. 54.3), at the expense of higher lung V20 (28.0% vs. 12.6%). In the groin, the largest improvements for 3D-CRT compared to 2D-RT were for anorectum Dmax (13.6 vs. 38.9 Gy), bowel D200cc (7.3 vs. 23.1 Gy), femur D50 (34.6 vs. 57.2 Gy), and genitalia Dmax (37.6 vs. 51.1 Gy). IMRT had further improvements compared to 3D-CRT for humerus Dmean (16.9 vs. 22.4 Gy), brachial plexus D5 (57.4 vs. 61.3 Gy), bladder D5 (26.8 vs. 36.5 Gy), and femur D50 (18.7 vs. 34.6 Gy). Fewer differences were observed between IMRT and VMAT.
Compared to 2D-RT and 3D-CRT, IMRT and VMAT had dosimetric advantages in the treatment of nodal regions of skin cancer patients.
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DOI: 10.3857/roj.2015.01592
PubMed: 27306779
PubMed Central: 4938352
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Dosimetric comparison of axilla and groin radiotherapy techniques for high-risk and locally advanced skin cancer</title><author><name sortKey="Mattes, Malcolm D" sort="Mattes, Malcolm D" uniqKey="Mattes M" first="Malcolm D." last="Mattes">Malcolm D. Mattes</name><affiliation wicri:level="1"><nlm:aff id="af1-roj-2015-01592">Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Zhou, Ying" sort="Zhou, Ying" uniqKey="Zhou Y" first="Ying" last="Zhou">Ying Zhou</name><affiliation wicri:level="1"><nlm:aff id="af2-roj-2015-01592">Department of Physics, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Berry, Sean L" sort="Berry, Sean L" uniqKey="Berry S" first="Sean L." last="Berry">Sean L. Berry</name><affiliation wicri:level="1"><nlm:aff id="af2-roj-2015-01592">Department of Physics, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Barker, Christopher A" sort="Barker, Christopher A" uniqKey="Barker C" first="Christopher A." last="Barker">Christopher A. Barker</name><affiliation wicri:level="1"><nlm:aff id="af1-roj-2015-01592">Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27306779</idno><idno type="pmc">4938352</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4938352</idno><idno type="RBID">PMC:4938352</idno><idno type="doi">10.3857/roj.2015.01592</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000850</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000850</idno><idno type="wicri:Area/Pmc/Curation">000850</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000850</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Dosimetric comparison of axilla and groin radiotherapy techniques for high-risk and locally advanced skin cancer</title><author><name sortKey="Mattes, Malcolm D" sort="Mattes, Malcolm D" uniqKey="Mattes M" first="Malcolm D." last="Mattes">Malcolm D. Mattes</name><affiliation wicri:level="1"><nlm:aff id="af1-roj-2015-01592">Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Zhou, Ying" sort="Zhou, Ying" uniqKey="Zhou Y" first="Ying" last="Zhou">Ying Zhou</name><affiliation wicri:level="1"><nlm:aff id="af2-roj-2015-01592">Department of Physics, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Berry, Sean L" sort="Berry, Sean L" uniqKey="Berry S" first="Sean L." last="Berry">Sean L. Berry</name><affiliation wicri:level="1"><nlm:aff id="af2-roj-2015-01592">Department of Physics, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Barker, Christopher A" sort="Barker, Christopher A" uniqKey="Barker C" first="Christopher A." last="Barker">Christopher A. Barker</name><affiliation wicri:level="1"><nlm:aff id="af1-roj-2015-01592">Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Radiation Oncology Journal</title><idno type="ISSN">2234-1900</idno><idno type="eISSN">2234-3164</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose:</title><p>Radiation therapy targeting axilla and groin lymph nodes improves regional disease control in locally advanced and high-risk skin cancers. However, trials generally used conventional two-dimensional radiotherapy (2D-RT), contributing towards relatively high rates of side effects from treatment. The goal of this study is to determine if three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), or volumetric-modulated arc therapy (VMAT) may improve radiation delivery to the target while avoiding organs at risk in the clinical context of skin cancer regional nodal irradiation.</p></sec><sec><title>Materials and Methods:</title><p>Twenty patients with locally advanced/high-risk skin cancers underwent computed tomography simulation. The relevant axilla or groin planning target volumes and organs at risk were delineated using standard definitions. Paired t-tests were used to compare the mean values of several dose-volumetric parameters for each of the 4 techniques.</p></sec><sec><title>Results:</title><p>In the axilla, the largest improvement for 3D-CRT compared to 2D-RT was for homogeneity index (13.9 vs. 54.3), at the expense of higher lung V<sub>20</sub> (28.0% vs. 12.6%). In the groin, the largest improvements for 3D-CRT compared to 2D-RT were for anorectum D<sub>max</sub> (13.6 vs. 38.9 Gy), bowel D<sub>200cc</sub> (7.3 vs. 23.1 Gy), femur D<sub>50</sub> (34.6 vs. 57.2 Gy), and genitalia D<sub>max</sub> (37.6 vs. 51.1 Gy). IMRT had further improvements compared to 3D-CRT for humerus D<sub>mean</sub> (16.9 vs. 22.4 Gy), brachial plexus D<sub>5</sub> (57.4 vs. 61.3 Gy), bladder D<sub>5</sub> (26.8 vs. 36.5 Gy), and femur D<sub>50</sub> (18.7 vs. 34.6 Gy). Fewer differences were observed between IMRT and VMAT.</p></sec><sec><title>Conclusion:</title><p>Compared to 2D-RT and 3D-CRT, IMRT and VMAT had dosimetric advantages in the treatment of nodal regions of skin cancer patients.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Burmeister, Bh" uniqKey="Burmeister B">BH Burmeister</name></author><author><name sortKey="Henderson, Ma" uniqKey="Henderson M">MA Henderson</name></author><author><name sortKey="Ainslie, J" uniqKey="Ainslie J">J Ainslie</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jouary, T" uniqKey="Jouary T">T Jouary</name></author><author><name sortKey="Leyral, C" uniqKey="Leyral C">C Leyral</name></author><author><name sortKey="Dreno, B" uniqKey="Dreno B">B Dreno</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="O Hara, J" uniqKey="O Hara J">J O'Hara</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Radiat Oncol J</journal-id><journal-id journal-id-type="iso-abbrev">Radiat Oncol J</journal-id><journal-id journal-id-type="publisher-id">ROJ</journal-id><journal-title-group><journal-title>Radiation Oncology Journal</journal-title></journal-title-group><issn pub-type="ppub">2234-1900</issn><issn pub-type="epub">2234-3164</issn><publisher><publisher-name>The Korean Society for Radiation Oncology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27306779</article-id><article-id pub-id-type="pmc">4938352</article-id><article-id pub-id-type="doi">10.3857/roj.2015.01592</article-id><article-id pub-id-type="publisher-id">roj-2015-01592</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject><subj-group subj-group-type="subheading"><subject>Physics Contribution</subject></subj-group></subj-group></article-categories><title-group><article-title>Dosimetric comparison of axilla and groin radiotherapy techniques for high-risk and locally advanced skin cancer</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Mattes</surname><given-names>Malcolm D.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="af1-roj-2015-01592"><sup>1</sup></xref><xref ref-type="author-notes" rid="fn1-roj-2015-01592"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Zhou</surname><given-names>Ying</given-names></name><degrees>MS</degrees><xref ref-type="aff" rid="af2-roj-2015-01592"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Berry</surname><given-names>Sean L.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="af2-roj-2015-01592"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Barker</surname><given-names>Christopher A.</given-names></name><degrees>MD</degrees><xref ref-type="corresp" rid="c1-roj-2015-01592"></xref><xref ref-type="aff" rid="af1-roj-2015-01592"><sup>1</sup></xref></contrib><aff id="af1-roj-2015-01592"><label>1</label>Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></aff><aff id="af2-roj-2015-01592"><label>2</label>Department of Physics, Memorial Sloan Kettering Cancer Center, New York, NY,<country>USA</country></aff></contrib-group><author-notes><corresp id="c1-roj-2015-01592">Correspondence: Christopher A. Barker, MD, Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Box 22, New York, NY 10065, USA. Tel: +1-212-639-8168, Fax: +1-212-717-3104, E-mail: <email>barkerc@mskcc.org</email></corresp><fn id="fn1-roj-2015-01592"><label>*</label><p>Current affiliation: Department of Radiation Oncology, West Virginia University Medical Center, Morgantown, WV, USA</p></fn></author-notes><pub-date pub-type="ppub"><month>6</month><year>2016</year></pub-date><pub-date pub-type="epub"><day>17</day><month>6</month><year>2016</year></pub-date><volume>34</volume><issue>2</issue><fpage>145</fpage><lpage>155</lpage><history><date date-type="received"><day>11</day><month>12</month><year>2015</year></date><date date-type="rev-recd"><day>2</day><month>2</month><year>2016</year></date><date date-type="accepted"><day>10</day><month>3</month><year>2016</year></date></history><permissions><copyright-statement>Copyright © 2016. The Korean Society for Radiation Oncology</copyright-statement><copyright-year>2016</copyright-year><license><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec><title>Purpose:</title><p>Radiation therapy targeting axilla and groin lymph nodes improves regional disease control in locally advanced and high-risk skin cancers. However, trials generally used conventional two-dimensional radiotherapy (2D-RT), contributing towards relatively high rates of side effects from treatment. The goal of this study is to determine if three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), or volumetric-modulated arc therapy (VMAT) may improve radiation delivery to the target while avoiding organs at risk in the clinical context of skin cancer regional nodal irradiation.</p></sec><sec><title>Materials and Methods:</title><p>Twenty patients with locally advanced/high-risk skin cancers underwent computed tomography simulation. The relevant axilla or groin planning target volumes and organs at risk were delineated using standard definitions. Paired t-tests were used to compare the mean values of several dose-volumetric parameters for each of the 4 techniques.</p></sec><sec><title>Results:</title><p>In the axilla, the largest improvement for 3D-CRT compared to 2D-RT was for homogeneity index (13.9 vs. 54.3), at the expense of higher lung V<sub>20</sub> (28.0% vs. 12.6%). In the groin, the largest improvements for 3D-CRT compared to 2D-RT were for anorectum D<sub>max</sub> (13.6 vs. 38.9 Gy), bowel D<sub>200cc</sub> (7.3 vs. 23.1 Gy), femur D<sub>50</sub> (34.6 vs. 57.2 Gy), and genitalia D<sub>max</sub> (37.6 vs. 51.1 Gy). IMRT had further improvements compared to 3D-CRT for humerus D<sub>mean</sub> (16.9 vs. 22.4 Gy), brachial plexus D<sub>5</sub> (57.4 vs. 61.3 Gy), bladder D<sub>5</sub> (26.8 vs. 36.5 Gy), and femur D<sub>50</sub> (18.7 vs. 34.6 Gy). Fewer differences were observed between IMRT and VMAT.</p></sec><sec><title>Conclusion:</title><p>Compared to 2D-RT and 3D-CRT, IMRT and VMAT had dosimetric advantages in the treatment of nodal regions of skin cancer patients.</p></sec></abstract><kwd-group><kwd>Intensity-modulated radiotherapy</kwd><kwd>Skin neoplasm</kwd><kwd>Conformal radiotherapy</kwd><kwd>Merkel cell carcinoma</kwd><kwd>Melanoma</kwd><kwd>Squamous cell carcinoma</kwd></kwd-group></article-meta></front><floats-group><fig id="f1-roj-2015-01592" orientation="portrait" position="float"><label>Fig. 1.</label><caption><p>Digitally reconstructed radiographs with representative two-dimensional radiotherapy fields (with clinical target volume superimposed in green) for (A) axilla and (B) groin radiotherapy for high-risk or locally advanced skin cancer.</p></caption><graphic xlink:href="roj-2015-01592f1"></graphic></fig><fig id="f2-roj-2015-01592" orientation="portrait" position="float"><label>Fig. 2.</label><caption><p>Computed tomography scans with representative isodose distributions for (A) two-dimensional radiotherapy, (B) three-dimensional conformal radiotherapy, (C) intensity-modulated radiotherapy, and (D) volumetric-modulated arc radiotherapy for high-risk and locally advanced skin cancer involving the axilla. Clinical target volume indicated in green.</p></caption><graphic xlink:href="roj-2015-01592f2"></graphic></fig><fig id="f3-roj-2015-01592" orientation="portrait" position="float"><label>Fig. 3.</label><caption><p>Computed tomography scans with representative isodose distributions for (A) two-dimensional radiotherapy, (B) three-dimensional conformal radiotherapy, (C) intensity-modulated radiotherapy, and (D) volumetric-modulated arc radiotherapy for high-risk and locally advanced skin cancer involving the groin. Clinical target volume indicated in green.</p></caption><graphic xlink:href="roj-2015-01592f3"></graphic></fig><table-wrap id="t1-roj-2015-01592" orientation="portrait" position="float"><label>Table 1.</label><caption><p>Organ at risk dose-volume constraints utilized in this study, along with the protocols from which they are derived</p></caption><table frame="hsides" rules="groups"><thead><tr><th valign="middle" align="center" rowspan="1" colspan="1">Organ</th><th valign="middle" align="center" rowspan="1" colspan="1">Volume</th><th valign="middle" align="center" rowspan="1" colspan="1">Dose (Gy)</th><th valign="middle" align="center" rowspan="1" colspan="1">Protocol</th></tr></thead><tbody><tr><td valign="top" align="left" rowspan="1" colspan="1">Brachial plexus</td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>max</sub></td><td valign="top" align="center" rowspan="1" colspan="1">66</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0619, 0617, 0615</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1"></td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>5%</sub></td><td valign="top" align="center" rowspan="1" colspan="1">60</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0619</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Esophagus</td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>mean</sub></td><td valign="top" align="center" rowspan="1" colspan="1">30</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 1016</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1"></td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>mean</sub></td><td valign="top" align="center" rowspan="1" colspan="1">34</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0623, 0617</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Heart</td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>33</sub></td><td valign="top" align="center" rowspan="1" colspan="1">50</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0436</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1"></td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>67</sub></td><td valign="top" align="center" rowspan="1" colspan="1">45</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0435, 0623, 0617</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1"></td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>100</sub></td><td valign="top" align="center" rowspan="1" colspan="1">40</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0435, 0623, 0617</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Proximal humerus</td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>50</sub></td><td valign="top" align="center" rowspan="1" colspan="1">50</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0630</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Larynx</td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>max</sub></td><td valign="top" align="center" rowspan="1" colspan="1">45</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0619, 0615, 0522</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1"></td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>mean</sub></td><td valign="top" align="center" rowspan="1" colspan="1">20</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 1016</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Liver</td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>50</sub></td><td valign="top" align="center" rowspan="1" colspan="1">35</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0436</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Total lung</td><td valign="top" align="center" rowspan="1" colspan="1">V<sub>37</sub></td><td valign="top" align="center" rowspan="1" colspan="1">20%</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0617, 0623</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1"></td><td valign="top" align="center" rowspan="1" colspan="1">V<sub>20</sub></td><td valign="top" align="center" rowspan="1" colspan="1">20%</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0630</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1"></td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>mean</sub></td><td valign="top" align="center" rowspan="1" colspan="1">20</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0617</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Spinal canal</td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>max</sub></td><td valign="top" align="center" rowspan="1" colspan="1">45</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0623, 0615</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Bladder</td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>50</sub></td><td valign="top" align="center" rowspan="1" colspan="1">35</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0529</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1"></td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>5</sub></td><td valign="top" align="center" rowspan="1" colspan="1">50</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0529</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Bowel bag</td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>20cc</sub></td><td valign="top" align="center" rowspan="1" colspan="1">45</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0529</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1"></td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>200cc</sub></td><td valign="top" align="center" rowspan="1" colspan="1">30</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0529</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Genitalia</td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>50</sub></td><td valign="top" align="center" rowspan="1" colspan="1">20</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0529</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1"></td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>5</sub></td><td valign="top" align="center" rowspan="1" colspan="1">40</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0529</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Lumbosacral plexus</td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>max</sub></td><td valign="top" align="center" rowspan="1" colspan="1">66</td><td valign="top" align="left" rowspan="1" colspan="1">Extrapolation from RTOG 0619, 0617, 0615</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1"></td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>max</sub></td><td valign="top" align="center" rowspan="1" colspan="1">60</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0522</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1"></td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>5%</sub></td><td valign="top" align="center" rowspan="1" colspan="1">60</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0619</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Proximal femur (weight bearing bone)</td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>50</sub></td><td valign="top" align="center" rowspan="1" colspan="1">50</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0630</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1"></td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>5</sub></td><td valign="top" align="center" rowspan="1" colspan="1">60</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0630</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Pelvic bones</td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>37</sub></td><td valign="top" align="center" rowspan="1" colspan="1">40</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0418</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Anorectum</td><td valign="top" align="center" rowspan="1" colspan="1">D<sub>50</sub></td><td valign="top" align="center" rowspan="1" colspan="1">30</td><td valign="top" align="left" rowspan="1" colspan="1">RTOG 0630</td></tr></tbody></table><table-wrap-foot><fn id="tfn1-roj-2015-01592"><p>RTOG, Radiation Therapy Oncology Group.</p></fn></table-wrap-foot></table-wrap><table-wrap id="t2-roj-2015-01592" orientation="portrait" position="float"><label>Table 2.</label><caption><p>Comparison of several dose-volumetric parameters for treatment-planning techniques for the axilla</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2" valign="middle" align="center" colspan="1">Parameter</th><th colspan="2" valign="top" align="center" rowspan="1">2D-RT<hr></hr></th><th colspan="2" valign="top" align="center" rowspan="1">3D-CRT<hr></hr></th><th colspan="2" valign="top" align="center" rowspan="1">IMRT<hr></hr></th><th colspan="2" valign="top" align="center" rowspan="1">VMAT<hr></hr></th></tr><tr><th valign="top" align="center" rowspan="1" colspan="1">Mean</th><th valign="top" align="center" rowspan="1" colspan="1">Median (range)</th><th valign="top" align="center" rowspan="1" colspan="1">Mean</th><th valign="top" align="center" rowspan="1" colspan="1">Median (range)</th><th valign="top" align="center" rowspan="1" colspan="1">Mean</th><th valign="top" align="center" rowspan="1" colspan="1">Median (range)</th><th valign="top" align="center" rowspan="1" colspan="1">Mean</th><th valign="top" align="center" rowspan="1" colspan="1">Median (range)</th></tr></thead><tbody><tr><td valign="top" align="left" rowspan="1" colspan="1">Homogeneity index</td><td valign="top" align="center" rowspan="1" colspan="1">54.3</td><td valign="top" align="center" rowspan="1" colspan="1">52.3 (20.2-87.3)</td><td valign="top" align="center" rowspan="1" colspan="1">13.9<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">14.3 (10.9-15.8)</td><td valign="top" align="center" rowspan="1" colspan="1">9.7<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">9.3 (7.3-12.6)</td><td valign="top" align="center" rowspan="1" colspan="1">12.5<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn5-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">12.5 (10.3-14.8)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Conformity index</td><td valign="top" align="center" rowspan="1" colspan="1">2.0</td><td valign="top" align="center" rowspan="1" colspan="1">1.7 (1.1-3.6)</td><td valign="top" align="center" rowspan="1" colspan="1">1.6</td><td valign="top" align="center" rowspan="1" colspan="1">1.6 (1.5-1.8)</td><td valign="top" align="center" rowspan="1" colspan="1">1.1<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">1.1 (1.1-1.2)</td><td valign="top" align="center" rowspan="1" colspan="1">1.2<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b</xref>,<xref rid="tfn5-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">1.2 (1.1-1.3)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Gradient index</td><td valign="top" align="center" rowspan="1" colspan="1">3.7</td><td valign="top" align="center" rowspan="1" colspan="1">3.6 (3.1-5.2)</td><td valign="top" align="center" rowspan="1" colspan="1">3.8</td><td valign="top" align="center" rowspan="1" colspan="1">3.7 (3.3-4.3)</td><td valign="top" align="center" rowspan="1" colspan="1">3.4<sup><xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">3.5 (3.0-3.8)</td><td valign="top" align="center" rowspan="1" colspan="1">3.1<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b</xref>,<xref rid="tfn5-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">3.1 (2.8-3.4)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Integral dose (Gy-L)</td><td valign="top" align="center" rowspan="1" colspan="1">233.7</td><td valign="top" align="center" rowspan="1" colspan="1">225.9 (152-368)</td><td valign="top" align="center" rowspan="1" colspan="1">236.6</td><td valign="top" align="center" rowspan="1" colspan="1">233.4 (189-330)</td><td valign="top" align="center" rowspan="1" colspan="1">204.5<sup><xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">201.2 (156-301)</td><td valign="top" align="center" rowspan="1" colspan="1">194.9<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b</xref>,<xref rid="tfn5-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">184.0 (145-289)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Ipsilateral lung D<sub>mean</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">15.7</td><td valign="top" align="center" rowspan="1" colspan="1">15.8 (13.6-18.2)</td><td valign="top" align="center" rowspan="1" colspan="1">24.8<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">24.1 (21.6-29.5)</td><td valign="top" align="center" rowspan="1" colspan="1">16.8<sup><xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">17.2 (14.3-18.1)</td><td valign="top" align="center" rowspan="1" colspan="1">16.7<sup><xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">17.2 (13.6-18.6)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Total lung D<sub>mean</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">8.4</td><td valign="top" align="center" rowspan="1" colspan="1">8.7 (6.5-10.5)</td><td valign="top" align="center" rowspan="1" colspan="1">13.4<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">12.9 (10.3-17.8)</td><td valign="top" align="center" rowspan="1" colspan="1">9.1<sup><xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">9.0 (7.0-10.8)</td><td valign="top" align="center" rowspan="1" colspan="1">9.1<sup><xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">8.8 (7.1-11.3)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Total lung V<sub>5</sub> (%)</td><td valign="top" align="center" rowspan="1" colspan="1">30.5</td><td valign="top" align="center" rowspan="1" colspan="1">31.2 (25.2-35.1)</td><td valign="top" align="center" rowspan="1" colspan="1">47.9<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">47.9 (33.7-57.3)</td><td valign="top" align="center" rowspan="1" colspan="1">41.5<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">41.0 (29.9-53.2)</td><td valign="top" align="center" rowspan="1" colspan="1">44.9<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b</xref>,<xref rid="tfn5-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">45.1 (32.6-53.1)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Total lung V<sub>20</sub> (%)</td><td valign="top" align="center" rowspan="1" colspan="1">12.6</td><td valign="top" align="center" rowspan="1" colspan="1">12.5 (9.5-16.2)</td><td valign="top" align="center" rowspan="1" colspan="1">28.0<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">27.3 (21.1-35.6)</td><td valign="top" align="center" rowspan="1" colspan="1">14.5<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">14.8 (11.1-17.4)</td><td valign="top" align="center" rowspan="1" colspan="1">13.8<sup><xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">14.1 (10.0-17.8)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Total lung V<sub>37</sub> (%)</td><td valign="top" align="center" rowspan="1" colspan="1">9.8</td><td valign="top" align="center" rowspan="1" colspan="1">9.8 (7.1-13.1)</td><td valign="top" align="center" rowspan="1" colspan="1">13.3<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">12.1 (9.9-20.7)</td><td valign="top" align="center" rowspan="1" colspan="1">7.4<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">7.3 (5.3-10.3)</td><td valign="top" align="center" rowspan="1" colspan="1">6.9<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b</xref>,<xref rid="tfn5-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">6.6 (4.1-11.1)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Humerus D<sub>max</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">61.6</td><td valign="top" align="center" rowspan="1" colspan="1">60.1 (57.3-69.8)</td><td valign="top" align="center" rowspan="1" colspan="1">60.3</td><td valign="top" align="center" rowspan="1" colspan="1">60.2 (58.7-62.5)</td><td valign="top" align="center" rowspan="1" colspan="1">58.4<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">58.9 (54.1-62.0)</td><td valign="top" align="center" rowspan="1" colspan="1">60.2<sup><xref rid="tfn5-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">60.1 (55.1-63.4)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Humerus D<sub>50</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">19.8</td><td valign="top" align="center" rowspan="1" colspan="1">16.2 (8.1-64.7)</td><td valign="top" align="center" rowspan="1" colspan="1">16.2</td><td valign="top" align="center" rowspan="1" colspan="1">14.8 (8.7-26.9)</td><td valign="top" align="center" rowspan="1" colspan="1">12.3</td><td valign="top" align="center" rowspan="1" colspan="1">11.3 (8.5-18.5)</td><td valign="top" align="center" rowspan="1" colspan="1">10.4<sup><xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b</xref>,<xref rid="tfn5-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">9.3 (7.0-17.3)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Humerus D<sub>mean</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">28.0</td><td valign="top" align="center" rowspan="1" colspan="1">26.1 (17.5-60.7)</td><td valign="top" align="center" rowspan="1" colspan="1">22.4</td><td valign="top" align="center" rowspan="1" colspan="1">22.1 (15.2-30.2)</td><td valign="top" align="center" rowspan="1" colspan="1">16.9<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">16.4 (13.0-22.2)</td><td valign="top" align="center" rowspan="1" colspan="1">16.1<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">14.1 (11.9-22.9)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Spinal canal D<sub>max</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">41.2</td><td valign="top" align="center" rowspan="1" colspan="1">46.6 (4.3-54.9)</td><td valign="top" align="center" rowspan="1" colspan="1">35.7</td><td valign="top" align="center" rowspan="1" colspan="1">33.0 (30.0-45.4)</td><td valign="top" align="center" rowspan="1" colspan="1">27.5<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">27.4 (23.7-35.6)</td><td valign="top" align="center" rowspan="1" colspan="1">24.4<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b</xref>,<xref rid="tfn5-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">24.0 (15.6-33.8)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Brachial plexus D<sub>max</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">63.0</td><td valign="top" align="center" rowspan="1" colspan="1">62.7 (58.4-71.3)</td><td valign="top" align="center" rowspan="1" colspan="1">62.1</td><td valign="top" align="center" rowspan="1" colspan="1">61.9 (58.9-64.9)</td><td valign="top" align="center" rowspan="1" colspan="1">58.4<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">58.5 (57.4-58.8)</td><td valign="top" align="center" rowspan="1" colspan="1">59.2<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b</xref>,<xref rid="tfn5-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">59.2 (58.8-60.1)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Brachial plexus D<sub>5</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">62.1</td><td valign="top" align="center" rowspan="1" colspan="1">61.2 (58.1-70.6)</td><td valign="top" align="center" rowspan="1" colspan="1">61.3</td><td valign="top" align="center" rowspan="1" colspan="1">61.2 (58.6-63.6)</td><td valign="top" align="center" rowspan="1" colspan="1">57.4<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">57.4 (56.6-57.9)</td><td valign="top" align="center" rowspan="1" colspan="1">58.2<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b</xref>,<xref rid="tfn5-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">58.1 (57.5-59.3)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Skin D<sub>max</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">65.3</td><td valign="top" align="center" rowspan="1" colspan="1">64.3 (59.9-74.4)</td><td valign="top" align="center" rowspan="1" colspan="1">62.6</td><td valign="top" align="center" rowspan="1" colspan="1">63.0 (59.9-64.1)</td><td valign="top" align="center" rowspan="1" colspan="1">61.1<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">60.6 (59.6-63.7)</td><td valign="top" align="center" rowspan="1" colspan="1">62.7<sup><xref rid="tfn5-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">62.5 (60.7-65.0)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Skin D<sub>50cc</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">57.2</td><td valign="top" align="center" rowspan="1" colspan="1">56.2 (52.0-67.5)</td><td valign="top" align="center" rowspan="1" colspan="1">53.8<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">54.6 (50.3-55.3)</td><td valign="top" align="center" rowspan="1" colspan="1">51.3<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">51.4 (46.8-55.3)</td><td valign="top" align="center" rowspan="1" colspan="1">50.6<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">51.2 (46.2-54.3)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Skin D<sub>300cc</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">39.4</td><td valign="top" align="center" rowspan="1" colspan="1">41.0 (28.5-53.9)</td><td valign="top" align="center" rowspan="1" colspan="1">29.6<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">30.9 (23.0-34.4)</td><td valign="top" align="center" rowspan="1" colspan="1">28.8<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">29.6 (22.1-33.4)</td><td valign="top" align="center" rowspan="1" colspan="1">28.2<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">29.0 (20.5-33.1)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Esophagus D<sub>max</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">35.2</td><td valign="top" align="center" rowspan="1" colspan="1">36.9 (10.1-52.8)</td><td valign="top" align="center" rowspan="1" colspan="1">32.1</td><td valign="top" align="center" rowspan="1" colspan="1">33.1 (13.4-44.2)</td><td valign="top" align="center" rowspan="1" colspan="1">26.3<sup><xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">27.3 (9.5-33.0)</td><td valign="top" align="center" rowspan="1" colspan="1">20.1<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b</xref>,<xref rid="tfn5-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">21.3 (4.1-34.7)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Esophagus D<sub>mean</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">5.5</td><td valign="top" align="center" rowspan="1" colspan="1">3.5 (2.3-19.3)</td><td valign="top" align="center" rowspan="1" colspan="1">5.4</td><td valign="top" align="center" rowspan="1" colspan="1">5.0 (27-8.7)</td><td valign="top" align="center" rowspan="1" colspan="1">3.8<sup><xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">3.5 (2.3-67)</td><td valign="top" align="center" rowspan="1" colspan="1">3.6<sup><xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">3.4 (2.3-6.1)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Larynx D<sub>max</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">24.3</td><td valign="top" align="center" rowspan="1" colspan="1">23.0 (5.5-54.4)</td><td valign="top" align="center" rowspan="1" colspan="1">22.8</td><td valign="top" align="center" rowspan="1" colspan="1">16.5 (9.5-52.7)</td><td valign="top" align="center" rowspan="1" colspan="1">19.8</td><td valign="top" align="center" rowspan="1" colspan="1">17.3 (10.1-44.8)</td><td valign="top" align="center" rowspan="1" colspan="1">15.0<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn4-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">13.3 (6.0-45.5)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Larynx D<sub>mean</sub> (Gy)</td><td valign="top" align="center" rowspan="1" colspan="1">8.6</td><td valign="top" align="center" rowspan="1" colspan="1">8.0 (2.5-21.7)</td><td valign="top" align="center" rowspan="1" colspan="1">7.6</td><td valign="top" align="center" rowspan="1" colspan="1">7.1 (2.6-17.5)</td><td valign="top" align="center" rowspan="1" colspan="1">7.9</td><td valign="top" align="center" rowspan="1" colspan="1">7.5 (6.0-11.1)</td><td valign="top" align="center" rowspan="1" colspan="1">5.1<sup><xref rid="tfn3-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="top" align="center" rowspan="1" colspan="1">4.3 (3.5-10.1)</td></tr></tbody></table><table-wrap-foot><fn id="tfn2-roj-2015-01592"><p>2D-RT, two-dimensional radiotherapy; 3D-CRT, three-dimensional conformal radiotherapy; IMRT, intensity-modulated radiotherapy; VMAT, volumetric-modulated arc therapy.</p></fn><fn id="tfn3-roj-2015-01592"><label>a)</label><p>Statistically significant (p < 0.05) difference between 2D-RT and either 3D-CRT, IMRT, or VMAT, respectively.</p></fn><fn id="tfn4-roj-2015-01592"><label>b)</label><p>Statistically significant difference between 3D-CRT and IMRT or VMAT, respectively.</p></fn><fn id="tfn5-roj-2015-01592"><label>c)</label><p>Statistically significant difference between IMRT and VMAT.</p></fn></table-wrap-foot></table-wrap><table-wrap id="t3-roj-2015-01592" orientation="portrait" position="float"><label>Table 3.</label><caption><p>Comparison of several dose-volumetric parameters for treatment-planning techniques for the groin</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2" valign="middle" align="center" colspan="1">Parameter</th><th colspan="2" valign="middle" align="center" rowspan="1">2D-RT<hr></hr></th><th colspan="2" valign="middle" align="center" rowspan="1">3D-CRT<hr></hr></th><th colspan="2" valign="middle" align="center" rowspan="1">IMRT<hr></hr></th><th colspan="2" valign="middle" align="center" rowspan="1">VMAT<hr></hr></th></tr><tr><th valign="middle" align="center" rowspan="1" colspan="1">Mean</th><th valign="middle" align="center" rowspan="1" colspan="1">Median (range)</th><th valign="middle" align="center" rowspan="1" colspan="1">Mean</th><th valign="middle" align="center" rowspan="1" colspan="1">Median (range)</th><th valign="middle" align="center" rowspan="1" colspan="1">Mean</th><th valign="middle" align="center" rowspan="1" colspan="1">Median (range)</th><th valign="middle" align="center" rowspan="1" colspan="1">Mean</th><th valign="middle" align="center" rowspan="1" colspan="1">Median (range)</th></tr></thead><tbody><tr><td valign="middle" align="left" rowspan="1" colspan="1">Homogeneity index</td><td valign="middle" align="center" rowspan="1" colspan="1">12.2</td><td valign="middle" align="center" rowspan="1" colspan="1">12.6 (8.1-19.4)</td><td valign="middle" align="center" rowspan="1" colspan="1">14.4</td><td valign="middle" align="center" rowspan="1" colspan="1">12.4 (11.0-24.5)</td><td valign="middle" align="center" rowspan="1" colspan="1">12.7</td><td valign="middle" align="center" rowspan="1" colspan="1">10.3 (7.6-26.7)</td><td valign="middle" align="center" rowspan="1" colspan="1">14.2</td><td valign="middle" align="center" rowspan="1" colspan="1">12.9 (10.0-21.8)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Conformity index</td><td valign="middle" align="center" rowspan="1" colspan="1">4.0</td><td valign="middle" align="center" rowspan="1" colspan="1">3.4 (8.6-25.1)</td><td valign="middle" align="center" rowspan="1" colspan="1">1.3<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">1.3 (1.3-1.4)</td><td valign="middle" align="center" rowspan="1" colspan="1">1.0<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">1.0 (1.0-1.1)</td><td valign="middle" align="center" rowspan="1" colspan="1">1.0<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">1.0 (0.9-1.0)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Gradient index</td><td valign="middle" align="center" rowspan="1" colspan="1">8.6</td><td valign="middle" align="center" rowspan="1" colspan="1">8.4 (7.2-11.5)</td><td valign="middle" align="center" rowspan="1" colspan="1">3.9<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">3.9 (3.4-4.3)</td><td valign="middle" align="center" rowspan="1" colspan="1">3.0<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">2.9 (2.8-3.4)</td><td valign="middle" align="center" rowspan="1" colspan="1">2.8<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b</xref>,<xref rid="tfn9-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">2.8 (2.6-3.0)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Integral dose (Gy-L)</td><td valign="middle" align="center" rowspan="1" colspan="1">209.3</td><td valign="middle" align="center" rowspan="1" colspan="1">207.5 (158-275)</td><td valign="middle" align="center" rowspan="1" colspan="1">132.8<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">118.3 (94-218)</td><td valign="middle" align="center" rowspan="1" colspan="1">101.7<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">95.9 (83-135)</td><td valign="middle" align="center" rowspan="1" colspan="1">104.7<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b</xref>,<xref rid="tfn9-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">99.3 (89-141)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Bladder D<sub>max</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">54.5</td><td valign="middle" align="center" rowspan="1" colspan="1">54.9 (45.3-58.8)</td><td valign="middle" align="center" rowspan="1" colspan="1">48.0</td><td valign="middle" align="center" rowspan="1" colspan="1">55.0 (23.6-61.3)</td><td valign="middle" align="center" rowspan="1" colspan="1">44.0<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">48.8 (24.7-59.3)</td><td valign="middle" align="center" rowspan="1" colspan="1">43.5<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">44.9 (22.9-59.3)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Bladder D<sub>5</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">46.4</td><td valign="middle" align="center" rowspan="1" colspan="1">49.1 (16.8-55.3)</td><td valign="middle" align="center" rowspan="1" colspan="1">36.5</td><td valign="middle" align="center" rowspan="1" colspan="1">38.2 (15.8-55.8)</td><td valign="middle" align="center" rowspan="1" colspan="1">26.8<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">27.8 (11.8-42.0)</td><td valign="middle" align="center" rowspan="1" colspan="1">28.0<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">29.8 (10.7-39.8)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Bladder D<sub>50</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">4.9</td><td valign="middle" align="center" rowspan="1" colspan="1">3.6 (2.2-17.9)</td><td valign="middle" align="center" rowspan="1" colspan="1">11.0<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">10.4 (6.2-17.8)</td><td valign="middle" align="center" rowspan="1" colspan="1">8.5<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">8.7 (4.0-13.9)</td><td valign="middle" align="center" rowspan="1" colspan="1">10.3<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn9-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">9.9 (4.5-17.6)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Anorectum D<sub>max</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">38.9</td><td valign="middle" align="center" rowspan="1" colspan="1">43.9 (7.1-55.3)</td><td valign="middle" align="center" rowspan="1" colspan="1">13.6<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">14.1 (8.8-20.5)</td><td valign="middle" align="center" rowspan="1" colspan="1">19.8<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">19.7 (10.7-31.6)</td><td valign="middle" align="center" rowspan="1" colspan="1">19.1<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">17.8 (12.1-26.8)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Anorectum D<sub>50</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">3.8</td><td valign="middle" align="center" rowspan="1" colspan="1">3.8 (27-5.4)</td><td valign="middle" align="center" rowspan="1" colspan="1">7.0<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">7.1 (5.3-8.2)</td><td valign="middle" align="center" rowspan="1" colspan="1">7.8<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">8.1 (3.2-11.2)</td><td valign="middle" align="center" rowspan="1" colspan="1">9.3<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn9-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">10.4 (3.5-14.5)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Bowel bag D<sub>20cc</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">52.2</td><td valign="middle" align="center" rowspan="1" colspan="1">56.0 (19.0-59.7)</td><td valign="middle" align="center" rowspan="1" colspan="1">45.3</td><td valign="middle" align="center" rowspan="1" colspan="1">53.9 (7.0-58.1)</td><td valign="middle" align="center" rowspan="1" colspan="1">39.6<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">50.0 (2.9-57.1)</td><td valign="middle" align="center" rowspan="1" colspan="1">38.0<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">46.1 (3.9-57.0)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Bowel bag D<sub>200cc</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">23.1</td><td valign="middle" align="center" rowspan="1" colspan="1">26.4 (17.6-49.9)</td><td valign="middle" align="center" rowspan="1" colspan="1">7.3<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">7.7 (1.5-14.9)</td><td valign="middle" align="center" rowspan="1" colspan="1">6.8<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">7.0 (1.1-15.3)</td><td valign="middle" align="center" rowspan="1" colspan="1">7.8<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn9-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">7.4 (1.4-16.8)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Femur D<sub>max</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">59.3</td><td valign="middle" align="center" rowspan="1" colspan="1">58.9 (57.9-61.9)</td><td valign="middle" align="center" rowspan="1" colspan="1">60.7<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">61.0 (58.7-62.2)</td><td valign="middle" align="center" rowspan="1" colspan="1">56.2<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">57.0 (50.6-58.7)</td><td valign="middle" align="center" rowspan="1" colspan="1">57.9<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b</xref>,<xref rid="tfn9-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">58.8 (54.4-59.7)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Femur D<sub>5</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">58.5</td><td valign="middle" align="center" rowspan="1" colspan="1">58.2 (57.1-60.8)</td><td valign="middle" align="center" rowspan="1" colspan="1">58.7</td><td valign="middle" align="center" rowspan="1" colspan="1">59.0 (56.4-61.3)</td><td valign="middle" align="center" rowspan="1" colspan="1">43.9<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">44.0 (35.4-53.4)</td><td valign="middle" align="center" rowspan="1" colspan="1">43.4<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">43.0 (3.6-52.9)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Femur D<sub>50</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">57.2</td><td valign="middle" align="center" rowspan="1" colspan="1">57.2 (55.6-59.2)</td><td valign="middle" align="center" rowspan="1" colspan="1">34.6<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">33.6 (29.2-40.0)</td><td valign="middle" align="center" rowspan="1" colspan="1">18.7<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">17.6 (13.5-27.0)</td><td valign="middle" align="center" rowspan="1" colspan="1">20.0<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">19.5 (14.3-25.5)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Genitalia D<sub>max</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">51.1</td><td valign="middle" align="center" rowspan="1" colspan="1">59.3 (20.6-64.1)</td><td valign="middle" align="center" rowspan="1" colspan="1">37.6<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">43.0 (10.6-61.7)</td><td valign="middle" align="center" rowspan="1" colspan="1">29.1<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">24.6 (3.2-58.3)</td><td valign="middle" align="center" rowspan="1" colspan="1">27.6<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">21.4 (4.1-58.3)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Genitalia D<sub>5</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">26.1</td><td valign="middle" align="center" rowspan="1" colspan="1">22.7 (3.5-56.2)</td><td valign="middle" align="center" rowspan="1" colspan="1">14.5</td><td valign="middle" align="center" rowspan="1" colspan="1">14.1 (3.3-28.2)</td><td valign="middle" align="center" rowspan="1" colspan="1">7.3<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">5.9 (1.5-16.6)</td><td valign="middle" align="center" rowspan="1" colspan="1">7.9<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">7.3 (2.5-14.9)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Genitalia D<sub>50</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">1.9</td><td valign="middle" align="center" rowspan="1" colspan="1">1.5 (1.0-3.8)</td><td valign="middle" align="center" rowspan="1" colspan="1">2.4</td><td valign="middle" align="center" rowspan="1" colspan="1">1.3 (0.7-6.1)</td><td valign="middle" align="center" rowspan="1" colspan="1">1.6</td><td valign="middle" align="center" rowspan="1" colspan="1">1.3 (0.7-3.0)</td><td valign="middle" align="center" rowspan="1" colspan="1">2.3</td><td valign="middle" align="center" rowspan="1" colspan="1">1.4 (0.9-6.7)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Skin D<sub>max</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">59.3</td><td valign="middle" align="center" rowspan="1" colspan="1">59.1 (57.3-62.4)</td><td valign="middle" align="center" rowspan="1" colspan="1">56.9<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">56.8 (54.4-60.6)</td><td valign="middle" align="center" rowspan="1" colspan="1">58.1</td><td valign="middle" align="center" rowspan="1" colspan="1">58.0 (57.2-59.6)</td><td valign="middle" align="center" rowspan="1" colspan="1">57.7<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">57.8 (55.2-60.1)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Skin D<sub>50cc</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">47.1</td><td valign="middle" align="center" rowspan="1" colspan="1">47.0 (43.1-50.3)</td><td valign="middle" align="center" rowspan="1" colspan="1">29.8<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">29.6 (26.3-35.7)</td><td valign="middle" align="center" rowspan="1" colspan="1">27.0<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">26.8 (24.8-30.4)</td><td valign="middle" align="center" rowspan="1" colspan="1">25.4<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">25.2 (22.8-29.9)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Skin D<sub>300cc</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">9.0</td><td valign="middle" align="center" rowspan="1" colspan="1">8.2 (4.4-17.0)</td><td valign="middle" align="center" rowspan="1" colspan="1">7.3</td><td valign="middle" align="center" rowspan="1" colspan="1">7.4 (6.4-7.9)</td><td valign="middle" align="center" rowspan="1" colspan="1">4.9<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">5.1 (3.8-5.5)</td><td valign="middle" align="center" rowspan="1" colspan="1">5.4<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn8-roj-2015-01592" ref-type="table-fn">b</xref>,<xref rid="tfn9-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">5.4 (47-5.7)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Lumbosacral plexus D<sub>max</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">56.6</td><td valign="middle" align="center" rowspan="1" colspan="1">56.0 (54.5-58.8)</td><td valign="middle" align="center" rowspan="1" colspan="1">22.8<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">23.9 (16.3-28.2)</td><td valign="middle" align="center" rowspan="1" colspan="1">22.9<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">21.9 (17.6-30.0)</td><td valign="middle" align="center" rowspan="1" colspan="1">21.2<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a</xref>,<xref rid="tfn9-roj-2015-01592" ref-type="table-fn">c)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">19.9 (17.8-27.4)</td></tr><tr><td valign="middle" align="left" rowspan="1" colspan="1">Lumbosacral plexus D<sub>5</sub> (Gy)</td><td valign="middle" align="center" rowspan="1" colspan="1">55.0</td><td valign="middle" align="center" rowspan="1" colspan="1">55.0 (52.7-57.9)</td><td valign="middle" align="center" rowspan="1" colspan="1">16.1<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">15.9 (13.9-19.2)</td><td valign="middle" align="center" rowspan="1" colspan="1">14.7<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">13.4 (11.3-21.0)</td><td valign="middle" align="center" rowspan="1" colspan="1">16.2<sup><xref rid="tfn7-roj-2015-01592" ref-type="table-fn">a)</xref></sup></td><td valign="middle" align="center" rowspan="1" colspan="1">16.0 (13.4-20.2)</td></tr></tbody></table><table-wrap-foot><fn id="tfn6-roj-2015-01592"><p>2D-RT, two-dimensional radiotherapy; 3D-CRT, three-dimensional conformal radiotherapy; IMRT, intensity-modulated radiotherapy; VMAT, volumetric-modulated arc therapy.</p></fn><fn id="tfn7-roj-2015-01592"><label>a)</label><p>Statistically significant (p < 0.05) difference between 2D-RT and either 3D-CRT, IMRT, or VMAT, respectively.</p></fn><fn id="tfn8-roj-2015-01592"><label>b)</label><p>Statistically significant difference between 3D-CRT and IMRT or VMAT, respectively.</p></fn><fn id="tfn9-roj-2015-01592"><label>c)</label><p>Statistically significant difference between IMRT and VMAT.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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